| Annuradha Vijayvargiya, | |
|
5041 Dallas Hwy Ste 402, Powder Springs, GA 30127-6458 | |
| (678) 354-5594 | |
| Not Available |
| Full Name | Annuradha Vijayvargiya |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 5041 Dallas Hwy Ste 402, Powder Springs, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912348921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC007381 (Georgia) | Primary |
| Entity Name | Personal Recovery Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220315000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Annuradha Vijayvargiya, 2143 Leatherstone Dr, Powder Springs, GA 30127-7038 Ph: (574) 229-1485 | Annuradha Vijayvargiya, 5041 Dallas Hwy Ste 402, Powder Springs, GA 30127-6458 Ph: (678) 354-5594 |
Kristen Machele Burroughs, M.ED; LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1308 Silverbrooke Xing, Powder Springs, GA 30127 Phone: 478-319-9098 | |
Suandria Houston, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3466 Hollow Stream Trl, Powder Springs, GA 30127 Phone: 720-772-6967 | |
Dr. Corlissa J Wilson, ED.D, LPC, NCC, NCSC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3217 Warren Creek Dr, Powder Springs, GA 30127 Phone: 404-435-3388 | |
Tashai T Gilman-brown, Counselor Medicare: Medicare Enrolled Practice Location: 3723 Gardenwick Rd, Powder Springs, GA 30127 Phone: 561-914-2707 | |
Daryel Lorenzo Scott Sr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 5227 Rosetrace Ter, Powder Springs, GA 30127 Phone: 678-524-4993 | |
Heidi Castaneda, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5041 Dallas Hwy, Suite 402, Powder Springs, GA 30127 Phone: 678-354-5594 | |
Robert Joseph Deletis, CADC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 1115 Crestworth Crossing, Powder Springs, GA 30127 Phone: 347-672-7199 |